Golden Shield ICICI Lombard General Insurance Co Ltd

4.5

Paybima Rating

Policy Brochure

Policy Wording

Claim Form

With age, health needs change, and accordingly, medical expenses also increase. It is common to be more dependent on healthcare services in the golden years, after the age of 60. One way to manage these expenses without compromising your healthcare needs is to have a health insurance plan. ICICI Lombard offers senior citizen health insurance plans that can cater to your healthcare expenses. The Golden Shield policy by ICICI Lombard is one such option.

ICICI Lombard Golden Shield Policy is an affordable health insurance for senior citizens. The policy offers a high sum insured that also restores upon exhaustion. In this guide, we will discuss the details of Golden Shield. So, read on to learn more.

Highlights of Golden Shield by ICICI Lombard Health Insurance

Network Hospitals Available - 9500+

Waiting Period for Pre-existing Diseases (PED) – 24 months

Claims Settlement Ratio – 99.7%

Policies Issued – 40,000+

Get free annual health check-ups with Golden Shield

60 minutes turnaround time (TAT) for cashless hospitalisation at a network hospital

Avail services at 10,300+ network hospitals across India

You have 24*7 customer support at ICICI Lombard

There is no cap on the upper entry age limit for the ICICI Lombard Golden Shield Policy.

Get all your insurance related queries answered

ICICI Lombard Golden Shield Policy: Highlights

Check out the table below for quick insight into the details of the ICICI Lombard Golden Shield Policy:

Particulars	Details
Policy Name	Golden Shield Policy
Insurance Company	ICICI Lombard General Insurance Co. Ltd.
Sum Insured Options	₹3 lakhs to ₹50 lakhs
Add-Ons	Claim protector Modification of Base Co-payment Voluntary deductible Routine Diagnostics and Minor Procedure coverPharmacy coverNursing at home
Entry Age	60 years and above (no cap on maximum entry age limit)
Waiting period	Initial waiting period: 30 days Pre-existing diseases: 24 months Specified diseases: 24 months
Network hospital	10,300+
Best suited for	Senior citizens

Wish to Enhance Your Coverage? Take a look at the Riders Available with the ICICI Lombard Golden Shield Policy

Check out the table below for details of add-on covers available with the Golden Shield Policy:

Add-on Covers	Details
Claim Protector	This add-on provides coverage for non-payable items during medical treatments
Modification of base co-payment	With this add-on, you can decrease the co-payment by 50% to 40,30 or 20%
Voluntary Deductible	With a voluntary deductible add-on, the insured has to pay 20% of the sum insured before the insurer pays. This is applicable once a policy year and once per person
Care Management Program	Get several coverages with this add-on, like teleconsultations, care calls, e-counselling, medical vault, second opinions, etc.
Care management plus program	This add-on offers coverages like routine diagnostics and minor procedure coverage, nursing at home coverage, pharmacy coverage, etc.

Disclaimer

* 10% Cumulative Bonus (CB) of the Sum Insured annually at the end of every policy year, provided the expiring plan has been free of claims and continuously renewed with the insurer. No accumulation of Cumulative Bonus beyond 100% of the Annual Sum Insured.

# Costs pertaining to Pre-Existing Disease (PED) treatment and any direct complications arising thereof shall be excluded until the end of 24 months or 2 years of regular coverage after the start date of the first policy by the insurance company.

(For Detailed Information Refer to the Policy Wording)

Features and Benefits of the ICICI Lombard Golden Shield Policy

ICICI Lombard Golden Shield Policy has multiple benefits and serves several healthcare purposes. Here are some of the highlighted features and benefits of the policy:

Suitable for Senior Citizens

Golden Shield by ICICI Lombard is best suited for senior citizens. The policy targets senior citizens aged 60 and above, addressing their medical needs. Golden Shield aims to transform the way senior citizens access medical care in their golden years.

No Entry Age Limit

Anyone above 60 years of age can purchase the Golden Shield Policy by ICICI Lombard. There is no limit on the maximum entry age for the policy. So, you need not limit yourself to Golden Shield.

Multiple Add-ons

The policy has a high sum-insured option and several base coverages. However, it also lets you customise the policy as per your needs by purchasing add-ons. There are multiple add-ons available for you to choose from.

Affordable Premiums

Keeping in mind the retirement age and income of the senior citizens, the policy has affordable premiums. So, you no longer need to worry about seeking a high-quality health insurance policy.

Reset benefit

The reset benefit of the policy adjusts the sum insured back to 100% after usage. It is applicable to diseases/illnesses for which there has been no prior treatment.

Pre-existing Diseases Covered

The policy not only covers medical conditions that occur after purchasing the policy but also PEDs. Pre-existing diseases are also covered in the Golden Shield Policy by ICICI Lombard. It has a waiting period of 24 months

Cashless Treatments

Cashless treatment is a hassle-free process where the policyholder does not have to pay from their pockets. The insurer directly settles the bills with the insurance provider. You can seek cashless treatments at 10,300+ network hospitals of ICICI Lombard

Peace of Mind

Above all, a health insurance policy like Golden Shield by ICICI Lombard offers peace of mind. When you know you have a health insurance policy that covers all the necessary medical expenses that may occur in your golden age, you can relax and focus on your healthcare priorities.

ICICI Lombard Golden Shield Policy: Eligibility Criteria

Understanding the eligibility criteria of the policy is crucial before you plan to purchase it. The eligibility criteria for the ICICI Lombard Golden Shield Policy are:

Entry Age

The entry age for the ICICI Lombard Golden Shield Policy is 60 years and above. There is no maximum entry age limit for the policy.

ICICI Lombard Golden Shield Policy: What is Covered?

The inclusion of the policy must be understood to maximise the use of the policy. The coverages of the ICICI Lombard Golden Shield Policy are:

In-patient Hospitalisation

When the hospitalisation exceeds 24 hours, it is covered under inpatient hospitalisation expenses. ICICI Lombard Golden Shield covers inpatient hospitalisation expenses.

Pre-hospitalisation

Before Hospitalisation, the treatment may begin at home. For up to 30 days prior to hospitalisation, medical expenses are covered by the policy.

Post-hospitalisation

After getting discharged from the hospital, medical treatments for up to 60 days are covered.

AYUSH Treatments

The policy also covers the AYUSH treatments (Ayurveda, Yoga, Unani, Siddha, and Homoeopathy). So, you may claim expenses under these alternative treatments

Reset Benefit

Under reset benefit, the sum insured amount is restored to 100% after exhaustion. It is applicable for diseases/illnesses for which no treatment has not been done before

Daycare Treatments

Multiple daycare treatments are covered in the policy. These are the treatments that do not require hospitalisation.

Air Ambulance

The cost of an air ambulance can be quite hefty and so, such expenses are also covered in the Golden Shield Policy

Room Rent Charges

The room rent charges during hospitalisation is also covered. You can further choose to enhance the coverage with add-ons.

Pre-existing Diseases

Pre-existing Diseases are covered under the policy. However, there is a waiting period of 24 months.

Annual Health Check-Ups

You get access to quality annual health check-ups with the ICICI Lombard Golden Shield Policy

Domiciliary Treatments

Not all treatments require hospitalisation. Some are done at home. So, treatments done at home are also covered

Second Medical Opinion

You can choose to have a second medical opinion for your health condition. Such expenses are covered in the policy

Organ Donor Expenses

In the case of organ donation, the expense of the organ donor is also covered under the Golden Shield Policy.

ICICI Lombard Golden Shield Policy: What is Not Covered?

Not everything is covered under a health insurance plan. Some conditions remain uncovered. In the case of the Aditya Birla Activ Assure Diamond plan, the exclusions are:

Self-inflicted Injuries

Self-inflicted physical injuries to the body, including suicide, are not covered

Maternity Expenses

The Golden Shield by ICICI Lombard does not cover maternity-related expenses

Fertility and Sterility Treatment

Any medical expenses arising due to fertility treatment are not covered

Cosmetic Treatments

The Golden Shield Policy does not cover the cost of cosmetic treatments as these are not medically required treatments

Intoxication/drug abuse

Any physical injuries due to drug abuse or use of intoxication are not covered in the policy.

Waiting period

There are different waiting periods, like a 30-day initial waiting period and 24 months for pre-existing illnesses and specified diseases. So, claims during the waiting period are not accepted

Investigation and evaluation

Diagnostic test expenses that are only intended for examination purposes are not covered.

Rest, cure, and rehab

Bed rest only without any treatment, is not covered as part of the policy coverage.

Unproven treatments

Treatment expenses that are not scientifically and medically proven are not covered

Weight control

Treatments aimed at weight management are not covered in the Golden Shield Policy

Change of gender

Treatments for gender change are not a part of the policy coverage, as it is a voluntary choice

Adventure sports

Injuries or damages due to participation in adventure sports are not covered in the health insurance policy

Excluded providers

There are certain providers that are excluded at ICICI Lombard. So, treatment at these places is not a part of the policy

Breach of law

If the insured member is found to be involved in illegal activities, the policy coverage may be denied

Eyesight treatment

Eyesight treatments that are not medically required are not covered

Dietary supplements

The cost of dietary supplements is not covered in the policy as it is a voluntary choice

Others

Apart from the exclusions mentioned above, certain other conditions are also excluded. These may include comfort treatments, circumcision, voluntary dental treatments, medical treatments outside India, etc.

Pros & Cons of Golden Shield by ICICI Lombard

Cashless hospitalisation

Cost coverage for AYUSH treatments

Reset benefit enabling the insured to reset 100% of the sum insured for one time during the policy term, if it has been completely exhausted during that particular term

E-counselling, teleconsultations, care calls, second opinions for terminal illnesses, yoga and meditation sessions, etc.

A cumulative bonus is guaranteed for every claim-free year

Treatment costs for cataracts and other modern treatments covered

100% death benefit offered to the nominee

Emergency care costs covered

Treatment cost for self-inflicted injury

Cosmetic surgery

Pre-existing diseases until the waiting period of 2 years

Civil war injury

Treatment of sexually transmitted diseases except for HIV/AIDS

Dental treatment due to accident

Hospitalisation without a doctor’s prescription/recommendation

Our Verdict on ICICI Lombard Golden Shield Policy?

ICICI Lombard is a well-known name in the realm of high-quality health insurance policies. The insurance provider has a claim settlement ratio of 97.16%, which is quite high. Such a claim settlement ratio shows that your chances of successful claim settlement are also high. The Golden Shield Policy by ICICI Lombard is aimed at senior citizens to provide them with uncompromised healthcare services in their golden age. The policy, along with the base cover, offers a range of add-ons that can be used to enhance the coverage further.

Speak to an Advisor

ICICI Lombard
Insurance Company

ICICI Lombard Health Insurance Company Ltd is a leading private general insurance company that offers a range of comprehensive and well-diversified products through multiple channels of distribution. This customer-centric company has a legacy of over 2 decades and is committed to its loyal customers. ICICI Lombard has over 312 branches with over 13,670 employees as of March 31, 2024. The insurer has issued over 36.2 million policies, honored over 2.9 million claims, and has a Gross Written Premium (GWP) of ₹255.94 billion for the year ended March 31, 2024.

Founded in

2001

Number of Claims

2.9 million claims paid

Number of Policies

36.2 million policies issued

Turnover (GWP)

INR 255.94 billion (FY 23-24)

Claims Experience

Claims Experience Rating 4.7

Claim Settlement Ratio (No. of claims)

99.7%

No. of Cashless Hospitals

9500+

Claims Incurred Ratio

77.33%

Benefits of Golden Shield by ICICI Lombard

In-patient Hospitalization
ICU Rent Limit	Covered
Room Rent Limit	Twin sharing (for SI below INR 10 Lacs) Single AC room (for SI above INR 10 Lacs)
Pre & Post Hospitalization
Post-hospitalization expenses are covered	as mentioned in the policy document of the plan
Post-hospitalization expenses are covered for up to	180 days after the date of discharge from the hospital
Pre-hospitalization expenses covered	as per the policy document of the plan
Pre-hospitalization expenses are covered up to	60 days before hospitalization
Day Care Treatment
No. of treatments covered	150+ Daycare treatments covered

Top Health Insurance Plans by ICICI Lombard General Insurance Co Ltd

Health Advantage

Lombard Elevate

Hand-hold by our expert advisor till making the right choice

Meet In Person Talk to an Advisor

70% of customers choose our advisor support for better coverage clarity.

Paybima Trusted by Millions of Customers

4.5

40+ Insurers

Wide range of trusted providers

560+ Advisors

Expert guidance at every step

31 Stores

Personalized service across India

Ask Anything as We Have Answers to Everything in Insurance

Some of the most popular insurance products offered by ICICI Lombard General Insurance are:

Travel Insurance
Bike Insurance
Motor Insurance
Home Insurance
Health Insurance
Business Insurance

The plan is designed to cover a wide array of treatment costs, such as:

Maternity benefit
Pre- and post-hospitalisation expenses
Emergency services
Outpatient treatment
Day care procedures
Donor expenses

Generally, expenses related to hospitalisation due to pregnancy-related complications, infertility, or abortions are excluded from coverage under the plan.

No, every insurer has a specific claim settlement ratio and it would not settle more than that. For instance, if the insurer has a 95% CSR, it means that it pays out 95 out of 100 claims received.

Yes, you are free to buy multiple health insurance policies from different insurers. This would ensure you wider coverage and also a variety of benefits.

Yes. You have several add-on options with the CICI Lombard Golden Shield Policy that you may purchase to enhance the coverage of your policy.

Yes, the policy has an initial waiting period. It is for 30 days. Additionally, it has a 24-month waiting period for specific diseases and a 36-month waiting period for pre-existing conditions.

The ICICI Lombard Golden Shield Policy is best suited for senior citizens. The policy is designed for senior members, enabling them to access high-quality healthcare services.